Actionable Diagnosis of Neuroleptospirosis by Next-Generation Sequencing
Open accessAbstract
A 14-year-old boy with severe combined immunodeficiency presented three times to a medical facility over a period of 4 months with fever and headache that progressed to hydrocephalus and status epilepticus necessitating a medically induced coma.Diagnostic workup including brain biopsy was unrevealing.Unbiased nextgeneration sequencing of the cerebrospinal fluid identified 475 of 3,063,784 sequence reads (0.016%) corresponding to leptospira infection.Clinical assays for leptospirosis were negative.Targeted antimicrobial agents were administered, and the patient was discharged home 32 days later with a status close to his premorbid condition.Polymerase-chain-reaction (PCR) and serologic testing at the Centers for Disease Control and Prevention (CDC) subsequently confirmed evidence of Leptospira santarosai infection.M ore than half the cases of meningoencephalitis remain undiagnosed, despite extensive clinical laboratory testing.[1][2][3][4] Because more than 100 different infectious agents can cause encephalitis, establishing a diagnosis with the use of cultures, serologic tests, and pathogen-specific PCR assays can be difficult.Unbiased next-generation sequencing has the potential to revolutionize our ability to discover emerging pathogens, especially newly identified viruses.[5][6][7][8] However, the usefulness of next-generation sequencing for the diagnosis of infectious diseases in a clinically relevant timeframe is largely unexplored.9 We used unbiased next-generation sequencing to identify a treatable, albeit rare, bacterial cause of meningoencephalitis.In this case, the results of next-generation sequencing contributed directly to a dramatic effect on the patient's care, resulting ultimately in a favorable outcome. C A SE R EPORTA 14-year-old boy with severe combined immunodeficiency (SCID) caused by adenosine deaminase deficiency and partial immune reconstitution after he had undergone two haploidentical bone marrow transplantations initially presented to the emergency department in early April 2013 after having had headache and fevers, with temperatures up to 39.4°C, for 6 days (Fig. 1A).He was admitted to the hospi-
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NGS was used to diagnose neuroleptospirosis in a critically ill 14-year-old boy with meningoencephalitis.
“NGS was used for the clinical diagnosis of neuroleptospirosis in a 14-year-old critically ill boy with meningoencephalitis19”
From Clinical metagenomics (2019) · cites this paper as [19]
That case was the first demonstration that mNGS can provide clinically actionable information, because diagnosis led to targeted antibiotics and recovery.
“this case was the first to demonstrate the utility of metagenomic NGS (mNGS) in providing clinically actionable information, as successful diagnosis prompted appropriate targeted antibiotic treatment and eventual recovery of the patient.”
From Clinical metagenomics (2019) · cites this paper as [19]
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Cites
Levett, P. N. (2001) · Clinical Microbiology Reviews · doi:10.1128/cmr.14.2.296-326.2001 · Cited by 2,374 · see citing works
A New Arenavirus in a Cluster of Fatal Transplant-Associated Diseases
Palacios, G. F., Druce, J. D., Du, L., Tran, T., Birch, C. J., Briese, T., Conlan, S., Quan, P., Hui, J., Marshall, J., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa073785 · Cited by 692 · see citing works
Beyond Viruses: Clinical Profiles and Etiologies Associated with Encephalitis
Glaser, C. A., Honarmand, S., Anderson, L. J., Schnurr, D. P., Forghani, B., Cossen, C. K., Schuster, F. L., Christie, L. J., & Tureen, J. H. (2006) · Clinical Infectious Diseases · doi:10.1086/509330 · Cited by 649 · see citing works
Stoddard, R. A., Gee, J. E., Wilkins, P. P., McCaustland, K. A., & Hoffmaster, A. R. (2009) · Diagnostic Microbiology and Infectious Disease · doi:10.1016/j.diagmicrobio.2009.03.014 · Cited by 570 · see citing works
Briese, T., Paweska, J. T., McMullan, L. K., Hutchison, S. K., Street, C., Palacios, G. F., Khristova, M. L., Weyer, J., Swanepoel, R., Egholm, M., et al. (2009) · PLoS Pathogens · doi:10.1371/journal.ppat.1000455 · Cited by 494 · see citing works
Naccache, S. N., Federman, S., Veeraraghavan, N., Zaharia, M., Lee, D., Samayoa, E., Bouquet, J., Greninger, A. L., Luk, K.-C., Enge, B., et al. (2014) · Genome Research · doi:10.1101/gr.171934.113 · Cited by 460 · see citing works
Self-citationGlaser, C. A., Gilliam, S., Schnurr, D. P., Forghani, B., Honarmand, S., Khetsuriani, N., Fischer, M., Cossen, C. K., & Anderson, L. J. (2003) · Clinical Infectious Diseases · doi:10.1086/367841 · Cited by 431 · see citing works
Infectious Encephalitis in France in 2007: A National Prospective Study
Mailles, A., & Stahl, J. ‐. (2009) · Clinical Infectious Diseases · doi:10.1086/648419 · Cited by 431 · see citing works
Genome reduction in Leptospira borgpetersenii reflects limited transmission potential
Bulach, D., Zuerner, R. L., Wilson, P. J., Seemann, T., McGrath, A., Cullen, P. A., Davis, J., Johnson, M., Kuczek, E. S., Alt, D. P., et al. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0603979103 · Cited by 365 · see citing works
Morgan, J., Bornstein, S. L., Karpati, A. M., Bruce, M. G., Bolin, C. A., Austin, C. C., Woods, C. W., Lingappa, J. R., Langkop, C. W., Davis, B., et al. (2002) · Clinical Infectious Diseases · doi:10.1086/340615 · Cited by 296 · see citing works
Leptospirosis in “Eco-Challenge” Athletes, Malaysian Borneo, 2000
Sejvar, J. J., Bancroft, E., Winthrop, K. L., Bettinger, J. A., Bajani, M. D., Bragg, S. L., Shutt, K. A., Kaiser, R., Marano, N., Popović, T., et al. (2003) · Emerging infectious diseases · doi:10.3201/eid0906.020751 · Cited by 292 · see citing works
Vinetz, J. M., Glass, G. E., Flexner, C. E., Mueller, P., & Kaslow, D. C. (1996) · Annals of Internal Medicine · doi:10.7326/0003-4819-125-10-199611150-00002 · Cited by 270 · see citing works
Naccache, S. N., Greninger, A. L., Lee, D., Coffey, L. L., Phan, T. G., Rein‐Weston, A., Aronsohn, A. I., Hackett, J., Delwart, E., & Chiu, C. Y. (2013) · Journal of Virology · doi:10.1128/jvi.02323-13 · Cited by 251 · see citing works
Self-citationChiu, C. Y. (2013) · Current Opinion in Microbiology · doi:10.1016/j.mib.2013.05.001 · Cited by 234 · see citing works
Self-citationGaspar, H. B., Aiuti, A., Porta, F., Candotti, F., Hershfield, M. S., & Notarangelo, L. D. (2009) · Blood · doi:10.1182/blood-2009-06-189209 · Cited by 217 · see citing works
Self-citationA Novel Rhabdovirus Associated with Acute Hemorrhagic Fever in Central Africa
Grard, G., Fair, J. N., Lee, D., Slikas, B., Steffen, I., Muyembe, J., Sittler, T., Veeraraghavan, N., Ruby, J. G., Wang, C., et al. (2012) · PLoS Pathogens · doi:10.1371/journal.ppat.1002924 · Cited by 213 · see citing works
Self-citationA metagenomic analysis of pandemic influenza A (2009 H1N1) infection in patients from North America
Greninger, A. L., Chen, E. C., Sittler, T., Scheinerman, A., Roubinian, N., Yu, G., Kim, E., Pillai, D. R., Guyard, C., Mazzulli, T., et al. (2010) · PLoS ONE · doi:10.1371/journal.pone.0013381 · Cited by 193 · see citing works
Self-citationGranerød, J., Tam, C. C., Crowcroft, N. S., Davies, N. W. S., Borchert, M., & Thomas, S. L. (2010) · Neurology · doi:10.1212/wnl.0b013e3181f11d65 · Cited by 187 · see citing works
Next-generation and whole-genome sequencing in the diagnostic clinical microbiology laboratory
Dunne, W. M., Westblade, L. F., & Ford, B. A. (2012) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-012-1641-7 · Cited by 161 · see citing works
Leptospirosis, Water Sports, and Chemoprophylaxis
Haake, D. A., Dundoo, M., Cader, R., Kubak, B., Hartskeerl, R. A., Sejvar, J. J., & Ashford, D. A. (2002) · Clinical Infectious Diseases · doi:10.1086/339942 · Cited by 160 · see citing works
Bourhy, P., Brémont, S., Zinini, F., Giry, C., & Picardeau, M. (2011) · Journal of Clinical Microbiology · doi:10.1128/jcm.02452-10 · Cited by 158 · see citing works
Discovery of a Novel Polyomavirus in Acute Diarrheal Samples from Children
Yu, G., Greninger, A. L., Iša, P., Phan, T. G., Martínez, M. Á., Sanchez, M. D. L. L., Contreras, J. F., Santos, J. I., Parsonnet, J., Miller, S. A., et al. (2012) · PLoS ONE · doi:10.1371/journal.pone.0049449 · Cited by 132 · see citing works
Self-citationTwo Methods for Rapid Serological Diagnosis of Acute Leptospirosis
Levett, P. N., Branch, S. L., Whittington, C. U., et al. (2001) · Clinical and Diagnostic Laboratory Immunology · doi:10.1128/cdli.8.2.349-351.2001 · Cited by 116 · see citing works
Outbreak of Leptospirosis among Adventure Race Participants in Florida, 2005
Stern, E. J., Galloway, R. L., Shadomy, S. V., et al. (2010) · Clinical Infectious Diseases · doi:10.1086/650578 · Cited by 112 · see citing works
Self-citationOutbreak of leptospirosis among triathlon participants in Germany, 2006
Brockmann, S., Piechotowski, I., Bock-Hensley, O., et al. (2010) · BMC Infectious Diseases · doi:10.1186/1471-2334-10-91 · Cited by 99 · see citing works
Ocular manifestations of leptospirosis.
Rathinam, S. R. (2006) · PubMed · Cited by 85 · see citing works
Mathew, T., Satishchandra, P., Mahadevan, A., et al. (2006) · PubMed · Cited by 76 · see citing works
Nalam, K., Ahmed, A., Devi, S. M., et al. (2010) · PLoS ONE · doi:10.1371/journal.pone.0012637 · Cited by 64 · see citing works
Swei, A., Russell, B. J., Naccache, S. N., Kabre, B., Veeraraghavan, N., Pilgard, M. A., Johnson, B. J. B., & Chiu, C. Y. (2013) · PLoS ONE · doi:10.1371/journal.pone.0062083 · Cited by 58 · see citing works
Self-citationChou, L., Chen, Y.-T., Lu, C., et al. (2012) · Gene · doi:10.1016/j.gene.2012.09.074 · Cited by 55 · see citing works
Chronic Meningitis in Weil's Disease
Murgatroyd, F. (1937) · BMJ · doi:10.1136/bmj.1.3965.7 · Cited by 35 · see citing works
Spurious serologic test results in patients receiving infusions of intravenous immune gammaglobulin.
Lichtiger, B., & Rogge, K. (1991) · PubMed · Cited by 35 · see citing works
Sünbül, M. (2001) · Scandinavian Journal of Infectious Diseases · doi:10.1080/00365540110076796 · Cited by 33 · see citing works
Thrombocytopenia in leptospirosis and role of platelet transfusion
Sharma, J. H., & Suryavanshi, M. (2007) · Asian Journal of Transfusion Science · doi:10.4103/0973-6247.33447 · Cited by 27 · see citing works
Demographic and clinical features of leptospirosis: three-year experience in central Taiwan.
Lin, P., Chi, C.-Y., Ho, M., et al. (2008) · PubMed · Cited by 18 · see citing works
A Disconnect between the Neurospirochetoses in Humans and Rodent Models of Disease
García‐Moncó, J. C., & Benach, J. L. (2013) · PLoS Pathogens · doi:10.1371/journal.ppat.1003288 · Cited by 14 · see citing works
‘Leptorapide’ – a one-step assay for rapid diagnosis of human leptospirosis
BROWNLOW, T., Kavanagh, O. V., Logan, E., et al. (2013) · Epidemiology and Infection · doi:10.1017/s0950268813002112 · Cited by 12 · see citing works
Neuroleptospirosis with Hydrocephalus and Very Elevated Cerebrospinal Fluid Protein
Sakellaridis, N., Panagopoulos, D., & Androulis, A. (2009) · Southern Medical Journal · doi:10.1097/smj.0b013e3181a0ae80 · Cited by 7 · see citing works
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Chiu, C. Y., & Miller, S. A. (2019) · Nature Reviews Genetics · doi:10.1038/s41576-019-0113-7 · Cited by 1,620 · see citing works
Self-citationClinical Metagenomic Next-Generation Sequencing for Pathogen Detection
Gu, W., Miller, S., & Chiu, C. Y. (2019) · Annual Review of Pathology: Mechanisms of Disease · doi:10.1146/annurev-pathmechdis-012418-012751 · Cited by 1,458 · see citing works
Self-citationQuick, J., Grubaugh, N. D., Pullan, S. T., Claro, I. M., Smith, A. D., Gangavarapu, K., Oliveira, G., Robles-Sikisaka, R., Rogers, T. F., Beutler, N. A., et al. (2017) · Nature Protocols · doi:10.1038/nprot.2017.066 · Cited by 1,190 · see citing works
Blauwkamp, T. A., Thair, S., Rosen, M. J., Blair, L., Lindner, M. S., Vilfan, I. D., Kawli, T., Christians, F. C., Venkatasubrahmanyam, S., Wall, G. D., et al. (2019) · Nature Microbiology · doi:10.1038/s41564-018-0349-6 · Cited by 962 · see citing works
Simner, P. J., Miller, S., & Carroll, K. C. (2018) · Clinical Infectious Diseases · doi:10.1093/cid/cix881 · Cited by 821 · see citing works
Self-citationMiller, J. M., Binnicker, M. J., Campbell, S., Carroll, K. C., Chapin, K. C., Gilligan, P. H., Gonzalez, M. D., Jerris, R. C., Kehl, S. C., Patel, R., et al. (2018) · Clinical Infectious Diseases · doi:10.1093/cid/ciy381 · Cited by 641 · see citing works
Validation of Metagenomic Next-Generation Sequencing Tests for Universal Pathogen Detection
Schlaberg, R., Chiu, C. Y., Miller, S., Procop, G. W., Weinstock, G., the Professional Practice Committee and Committee on Laboratory Practices of the American Society for Microbiology, & the Microbiology Resource Committee of the College of American Pathologists (2017) · Archives of Pathology & Laboratory Medicine · doi:10.5858/arpa.2016-0539-ra · Cited by 550 · see citing works
Self-citationGreninger, A. L., Naccache, S. N., Federman, S., Yu, G., Mbala, P., Bres, V., Stryke, D., Bouquet, J., Somasekar, S., Linnen, J. M., et al. (2015) · Genome Medicine · doi:10.1186/s13073-015-0220-9 · Cited by 558 · see citing works
Self-citationNaccache, S. N., Federman, S., Veeraraghavan, N., Zaharia, M., Lee, D., Samayoa, E., Bouquet, J., Greninger, A. L., Luk, K.-C., Enge, B., et al. (2014) · Genome Research · doi:10.1101/gr.171934.113 · Cited by 460 · see citing works
Self-citationNext-generation sequencing: insights to advance clinical investigations of the microbiome
Wensel, C. R., Pluznick, J. L., Salzberg, S. L., & Sears, C. L. (2022) · Journal of Clinical Investigation · doi:10.1172/jci154944 · Cited by 437 · see citing works
Langelier, C., Kalantar, K. L., Moazed, F., Wilson, M. R., Crawford, E. D., Deiss, T., Belzer, A., Bolourchi, S., Caldera, S., Fung, M., et al. (2018) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1809700115 · Cited by 411 · see citing works
Self-citationGoldberg, B., Sichtig, H., Geyer, C., Ledeboer, N., & Weinstock, G. M. (2015) · mBio · doi:10.1128/mbio.01888-15 · Cited by 360 · see citing works
Naccache, S. N., Peggs, K. S., Mattes, F. M., Phadke, R., Garson, J. A., Grant, P., Samayoa, E., Federman, S., Miller, S., Lunn, M. P., et al. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/ciu912 · Cited by 294 · see citing works
Self-citationComprehensive benchmarking and ensemble approaches for metagenomic classifiers
McIntyre, A. B. R., Ounit, R., Afshinnekoo, E., Prill, R. J., Hénaff, E., Alexander, N., Minot, S. S., Danko, D., Foox, J., Ahsanuddin, S., et al. (2017) · Genome Biology · doi:10.1186/s13059-017-1299-7 · Cited by 342 · see citing works
Next-Generation Sequencing for Infectious Disease Diagnosis and Management
Lefterova, M. I., Suarez, C. J., Banaei, N., & Pinsky, B. A. (2015) · The Journal of Molecular Diagnostics · doi:10.1016/j.jmoldx.2015.07.004 · Cited by 207 · see citing works
Hong, D. K., Blauwkamp, T. A., Kertesz, M., Bercovici, S., Truong, C., & Banaei, N. (2018) · Diagnostic Microbiology and Infectious Disease · doi:10.1016/j.diagmicrobio.2018.06.009 · Cited by 201 · see citing works
Strong, M. J., Xu, G., Morici, L., Splinter Bon-Durant, S., Baddoo, M., Lin, Z., Fewell, C., Taylor, C. M., & Flemington, E. K. (2014) · PLoS Pathogens · doi:10.1371/journal.ppat.1004437 · Cited by 186 · see citing works
Flygare, S., Simmon, K., Miller, C., Qiao, Y., Kennedy, B., Di Sera, T., Graf, E. H., Tardif, K. D., Kapusta, A., Rynearson, S., et al. (2016) · Genome Biology · doi:10.1186/s13059-016-0969-1 · Cited by 164 · see citing works
Comparison of microbial DNA enrichment tools for metagenomic whole genome sequencing
Thoendel, M., Jeraldo, P. R., Greenwood-Quaintance, K. E., Yao, J. Z., Chia, N., Hanssen, A. D., Abdel, M. P., & Patel, R. (2016) · Journal of Microbiological Methods · doi:10.1016/j.mimet.2016.05.022 · Cited by 150 · see citing works
Gut microbiome of an 11th Century A.D. pre-Columbian Andean mummy
Santiago-Rodriguez, T. M., Fornaciari, G., Luciani, S., Dowd, S. E., Toranzos, G. A., Marota, I., & Cano, R. J. (2015) · PLoS ONE · doi:10.1371/journal.pone.0138135 · Cited by 123 · see citing works
Radmard, S., Reid, S., Ciryam, P., Boubour, A., Ho, N., Zucker, J., Sayre, D., Greendyke, W. G., Miko, B. A., Pereira, M. R., et al. (2019) · Frontiers in Neurology · doi:10.3389/fneur.2019.00281 · Cited by 116 · see citing works
Laboratory diagnosis of central nervous system infection
He, T., Kaplan, S., Kamboj, M., & Tang, Y.-W. (2016) · Current Infectious Disease Reports · doi:10.1007/s11908-016-0545-6 · Cited by 81 · see citing works
State-of-the-Art Microbiologic Testing for Community-Acquired Meningitis and Encephalitis
Polage, C. R., & Cohen, S. H. (2016) · Journal of Clinical Microbiology · doi:10.1128/jcm.00289-16 · Cited by 43 · see citing works
Molecular diagnostics in cerebrospinal fluid for the diagnosis of central nervous system infections
Olie, S. E., Andersen, C. Ø., van de Beek, D., & Brouwer, M. C. (2024) · Clinical Microbiology Reviews · doi:10.1128/cmr.00021-24 · Cited by 38 · see citing works
“The first clinical application of mNGS in CNS infections was described in 2014, when a case of neuroleptospirosis was detected by mNGS (309).”
Miller, S., Naccache, S., Samayoa, E., Messacar, K., Arevalo, S., Federman, S., Stryke, D., Pham, E., Fung, B., Bolosky, W., et al. (2018) · doi:10.1101/330381 · Cited by 583 · see citing works
Self-citationHasan, M. R., Sundararaju, S., Tang, P., Tsui, K.-M., Lopez, A. P., Janahi, M., Tan, R., & Tilley, P. (2020) · Scientific Reports · doi:10.1038/s41598-020-68159-z · Cited by 37 · see citing works
Genomic and serologic characterization of enterovirus A71 brainstem encephalitis
Leon, K. E., Schubert, R. D., Casas-Alba, D., Hawes, I. A., Ramachandran, P. S., Ramesh, A., Pak, J. E., Wu, W., Cheung, C. K., Crawford, E. D., et al. (2020) · Neurology Neuroimmunology & Neuroinflammation · doi:10.1212/nxi.0000000000000703 · Cited by 32 · see citing works
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Vila, J., Bosch, J., & Muñoz-Almagro, C. (2021) · Enfermedades Infecciosas y Microbiología Clínica · doi:10.1016/j.eimc.2020.03.001 · Cited by 24 · see citing works
Emerging diagnostic and therapeutic tools for central nervous system infections
Wilson, M., & Tyler, K. L. (2016) · JAMA Neurology · doi:10.1001/jamaneurol.2016.3617 · Cited by 11 · see citing works
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Gutierrez, M., & Emmanuel, P. J. (2018) · Advances in Pediatrics · doi:10.1016/j.yapd.2018.04.005 · Cited by 11 · see citing works
What's next (generation) for the diagnosis of chronic meningitis?
Tyler, K. L. (2018) · JAMA Neurology · doi:10.1001/jamaneurol.2018.0473 · Cited by 3 · see citing works
- Authors
- Wilson, M. R., Naccache, S. N., Samayoa, E., Biagtan, M., Bashir, H., Yu, G., Salamat, S. M., Somasekar, S., Federman, S., Miller, S., Sokolic, R., Garabedian, E., Candotti, F., Buckley, R. H., Reed, K. D., Meyer, T. L., Seroogy, C. M., Galloway, R., Henderson, S. L., Gern, J. E., DeRisi, J. L., & Chiu, C. Y.
- Affiliations
- University of California, San Francisco (US)
- National Institutes of Health (US)
- Duke University (US)
- Centers for Disease Control and Prevention (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2014-06-19
- Volume
- 370
- Issue
- 25
- Pages
- 2408-2417
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC4134948
- OpenAlex
- W2106780559
- Cited by
- 977
- References
- 38
- Citations by year
- 2026: 40 · 2025: 75 · 2024: 101 · 2023: 94 · 2022: 91 · 2021: 114 · 2020: 109 · 2019: 85 · 2018: 66 · 2017: 57 · 2016: 69 · 2015: 51 · 2014: 23 · 2013: 2
- FWCI
- 48.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Howard Hughes Medical Institute
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL105704)
- Topics
- Life Sciences › Immunology and Microbiology › Parasitology › Leptospirosis research and findings
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Keywords
- neuroleptospirosis, Leptospira santarosai, leptospirosis, meningoencephalitis, severe combined immunodeficiency, adenosine deaminase deficiency, status epilepticus, hydrocephalus, pediatric infection
- MeSH terms
- Adenosine Deaminase, Adolescent, Agammaglobulinemia, Biopsy, Brain, Cerebrospinal Fluid, DNA, Bacterial, Fever, Headache, Humans, Leptospira, Leptospirosis, Male, Meningoencephalitis, Severe Combined Immunodeficiency, Sequence Analysis, DNA
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